ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Stigmatization negatively affects exercise compliance in children with adolescent idiopathic scoliosis: a cross-sectional study.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveAdolescent Idiopathic Scoliosis (AIS) is a spinal deformity that can impact both physical and psychosocial well-being. Stigmatization, particularly during adolescence, may influence adherence to conservative treatment strategies, including exercise therapy. This study examines the relationship between scoliosis-related stigma and adherence to exercise therapy in AIS patients.
methodsThis cross-sectional study included 88 AIS patients (mean age: 14.8 ± 2.5 years; 77.3% female) who were receiving conservative treatment. Only patients enrolled in a physiotherapeutic scoliosis-specific exercise program as part of their routine follow-up were included. Exercise adherence was classified based on the frequency of weekly home exercise sessions and patients' self-reported regularity. Adherence was defined as exercising at least three days per week and rating adherence as 'Moderately regular,' 'Quite regular,' or 'Completely regular'. Scoliosis-related stigma was assessed using the Adolescent Idiopathic Scoliosis Stigma Assessment Scale (AIS-SAS). Statistical analyses included Mann-Whitney U tests, chi-square tests, and multivariate logistic regression.
resultsExercise non-adherence was identified in 68.2% of patients. Non-adherent participants had significantly higher scoliosis-related stigma scores (median: 9.7 vs. 5.6, p = 0.014) and brace-related stigma scores (median: 40.0 vs. 25.0, p = 0.016). Patients receiving both bracing and exercise therapy reported higher scoliosis-related stigma scores than those receiving exercise alone (p = 0.004). Among patients receiving bracing, stigma scores were significantly higher in those who did not wear the brace for the recommended duration (p = 0.043 for scoliosis-related stigma, p = 0.019 for brace-related stigma). Multivariate logistic regression showed that both scoliosis-related stigma (p = 0.015, OR = 1.107) and brace treatment (p = 0.041, OR = 3.225) were significant predictors of non-adherence.
conclusionPerceived stigmatization may contribute to exercise non-adherence in adolescents with AIS. Increasing awareness and supportive interventions could enhance treatment success and quality of life. Longitudinal studies are needed to clarify causality and explore other psychosocial factors.
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